TINC Membership Form

[Please copy and paste this form either in an e-mail to cubatravel@earthlink.net or in a Word document sent as an attachment or by mail to Fund for Reconciliation and Development, 145 Palisade Street, Suite 401, Dobbs Ferry, NY 10522]

I support ending all US restrictions on travel to Cuba and wish to be a member of the Travel Industry Network on Cuba.

Name _____________________________

Title/position _______________________

Business or organization

_________________________________

Address __________________________

__________________Zip _____

Phone ___________ e-mail ___________

Name of your Representative in Congress

________________________________

Relationship to travel industry:

___ agent ___ tour operator ___ educator
___ other _____________

Membership contribution ___ $25 ___ $ 50
__ other $ ____

Contributions my be made by check to Fund for Reconciliation and Development/TINC or on line here.